Page 77 - Inventory Report

Revisions $1.19 - revised unit cost Unit Cost Approved Unit Cost Approved Unit Cost Approved Unit Cost Approved
AA

Z $ 1,021,287.64

Extended

Y $ 15.26 $ 14.87 $ 14.87 $ 14.28 $ 10.65 $21,059.19 $ 8,795.28 $ 7,588.44 $ 6,105.43 $ 5,474.44 $ 4,637.48 $ 3,624.38 $ 3,338.29 $ 2,598.82 $ 2,539.46 $ 2,492.25 $ 2,275.68 $ 2,273.59 $ 2,238.42

Unit
X Cost $ 3.81 $ 3.72 $ 3.72 $ 1.19 $ 2.66 ######## $ 56.91 ######## $109.03 $912.41 $220.83 ######## $333.83 $ 86.63 $423.24 $108.36 $ 91.03 $454.72 $111.92

Package Cost

W $ 91.55 $ 22.31 $ 89.22 $ 28.56 $ 63.92 ######## $ 569.08 ######## ######## $ 912.41 ######## ######## ######## $ 866.27 $ 423.24 ######## $ 91.03 $ 454.72 ########

V SOURCE 6770003320 7300006564 7300006564 MIS NADAC/UPD MIS NADAC 7300009403 7300002448 7300001790 7300000841 7300012230 7300006973 7300012444 7300011656 7300019363 7300019040 7300000396 MIS NADAC 7300018820 7300012239

U AHFS ANTIARRHYTHMIC AGENTS, CLASS Ib ANTIARRHYTHMICS 08140800-AZOLES 08140800-AZOLES PREPARATIONS ATED 80040000-ANTITOXINS 80120000-VACCINES ANTIPARATHYROID NEUROMUSCULAR 80040000-ANTITOXINS HEMATOPOIETIC 72000000-LOCAL (PARENTERAL) HEMATOPOIETIC 80040000-ANTITOXINS 48240000-MUCOLYTIC AGENTS 80040000-ANTITOXINS 80040000-ANTITOXINS CEPHALOSPORINS, THIRD GENERATION
24040408- 40120000- REPLACEMENT 40120000- REPLACEMENT AND IMMUNE 68240400- 12202000- AND IMMUNE GLOBULINS 20160000- 92320000- COMPLEMENT INHIBITORS ANESTHETICS 20160000- AND IMMUNE GLOBULINS AND IMMUNE GLOBULINS AND IMMUNE GLOBULINS 08120612-

DEA
T CLAS S

S GENER IC CODE 26898 69790 69790 2962 2964 15446 98534 26431 32770 29309 13206 14778 30775 44767 44608 27200 29305 29308 37609

MANUFACTURER Inc.

R B. Braun Medical Inc. Renaissance SSA, LLC Hospira, Inc. B. Braun Medical Inc. B. Braun Medical Inc. BTG International Inc. GlaxoSmithKline Biologicals SA Mylan Institutional LLC AbbVie Inc. GRIFOLS USA, LLC Inc Amgen Teva Pharmaceuticals USA, Inc. Pacira Pharmaceuticals Inc. Pfizer Laboratories Div Pfizer Inc GRIFOLS USA, LLC Genentech, GRIFOLS USA, LLC GRIFOLS USA, LLC Merck Sharp & Dohme Corp.

DOSE FORM S INJECTION, S INJECTION, S INJECTION, S INJECTION, S INJECTION, N INJECTION, S INJECTION,

Q INTRAVENOU SOLUTION INTRAVENOU S INJECTION INTRAVENOU SOLUTION INTRAVENOU SOLUTION INTRAVENOU INTRAVENOU INTRAMUSCU LAR 10X1ML INJECTION, INTRAMUSCU LAR/SUBCUT INTRAVENOU S INJECTION INTRAVENOU S; 200 ML SUBCUTANE INTRAVENOU SUBCUTANE OUS INJECTION, INFILTRATIO SUSPENSION INTRAVENOU INFILTRATIO N; INTRAMUSCU RESPIRATOR INTRAVENOU S; SUBCUTANE INTRAVENOU S; 100 ML SUBCUTANE INTRAVENOU POWDER, 10X1EA LYOPHILIZED

SIZE S; 10X1ML S; Y
P TXT 24X500 ML 6X100M L 24X100 ML 24X250 ML 24X500 ML 1 EA 2 ML 10X20M L 10X1.6 ML 3 ML 10X20M L 1 ML 30X2.5 ML 10 ML

UOI
O SIZE

PACK AGE 500 100 100 250 500 1 1 2 20 200 1.6 3 20 1 1 2.5 10 100 1
N SIZE

M STRENG TH .4; 5g/100mL ; g/100mL 2mg/mL 2mg/mL 0.9g/100 mL 3g/100mL 40mg/1 1440[iU]/ mL 200U/ml 10mg/mL 10g/100m L 480ug/1.6 mL 10mg/mL 13.3mg/m L 10000[iU] /mL 300[iU]/m L 1mg/mL 10g/100m L 10g/100m L 1g/1; 0.5g/1

L GENERIC LIDOCAINE HYDROCHL ORIDE ANHYDROU S; FLUCONAZ OLE FLUCONAZ OLE SODIUM CHLORIDE SODIUM CHLORIDE OVINE DIGOXIN HEPATITIS A VIRUS STRAIN CALCITONI N SALMON CISATRACU RIUM HUMAN IMMUNOGL OBULIN G FILGRASTI M ICATIBANT ACETATE BUPIVACAI NE ERYTHROP OIETIN HUMAN RABIES VIRUS DORNASE ALFA HUMAN IMMUNOGL OBULIN G HUMAN IMMUNOGL OBULIN G CEFTOLOZ ANE SULFATE; TAZOBACT

K TRADE LIDOCAINE HYDROCHL ORIDE AND DEXTROSE FLUCONAZ OLE IN SODIUM FLUCONAZ OLE IN SODIUM SODIUM CHLORIDE SODIUM CHLORIDE DIGIFAB HAVRIX MIACALCIN NIMBEX GAMUNEX- C NEUPOGEN ICATIBANT EXPAREL RETACRIT HYPERRAB PULMOZYM E GAMUNEX- C GAMUNEX- C ZERBAXA

J MERIDIAN DESC LIDOCAINE HCL IN 5% DEXTROSE IV SOLN P5941 500 FLUCONAZOLE-NACL PIGGYBACK 200MG/0.1L 100 FLUCONAZOLE-NACL PIGGYBACK 200MG/0.1L 100 SODIUM CHLORIDE IV SOLN L8002 250 SODIUM CHLORIDE IV SOLN L8051 500 DIGIFAB VIAL 40 MG 1 HAVRIX SYRINGE 1440/ML 1 MIACALCIN VIAL 200/ML 2 NIMBEX VIAL 10 MG/ML 20 GAMUNEX-C VIAL 20 G/200ML 200 NEUPOGEN VIAL 480MCG/1.6 1.6 ICATIBANT SYRINGE 30 MG/3 ML 3ICATIBANT 30 MG/3 EXPAREL VIAL 13.3 MG/ML 20 RETACRIT VIAL 10000/ML 1 HYPERRAB VIAL 300IU/ML 1 PULMOZYME SOLUTION 1 MG/ML GAMUNEX-C VIAL 1 G/10 ML 10 GAMUNEX-C VIAL 10 G/100ML 100 ZERBAXA VIAL 1.5 G 1

Med Desc Lidocaine Hcl In 5% Dextrose 4mg/Ml IVSL 24X500ML FLUCONAZ/SOD 200MG 6X100ML Fluconazole/Sod Cl 200mg/100ml IPSL 24X100ML SODIUM CL 0.9% 24X250ML EXC SODIUM CL 3% 24X500ML EXC Digifab 40mg PWVL Havrix 1440elu/Ml SYRN 10X1ML Miacalcin 200u/Ml MDV 2 ML Nimbex 10mg/Ml SDV 10X20ML Gamunex-C 0.1 SDPF 200 ML Neupogen ICATIBANT 10MG/ML 3ML Exparel Dshp 13.3mg/Ml SDPF 10X20ML RETACRIT 10000U/ML 10X1ML Hyperrab 300u/Ml SDPF 1 ML Pulmozyme 1mg/Ml AMIH 30X2.5ML GAMUNEX-C 10% 1GM 10ML WHS Gamunex-C 0.1 SDPF 100 ML Zerbaxa 1-0.5gm PWVL 10X1EA

I 480mcg/1.6ml SDPF

Alert /Ext/ Pkg /Ext /Ext/ Pkg /Ext/ Pkg /Ext/ Pkg /Pkg /Pkg /Pkg /Pkg /Pkg
H 1 EA SPD

1 1601 1602 1603 1604 1605 1606 1607 1608 1609 1610 1611 1612 1613 1614 1615 1616 1617 1618 1619